By John Lyon
Arkansas News Bureau
LITTLE ROCK — The first concrete benefit from the health care reform law passed by Congress this year — health insurance for people with pre-existing conditions — is about to become available in Arkansas, state Insurance Commissioner Jay Bradford said today.
“It takes a long time for something this massive to get into effect. This is an early entry to show people that this is what they were talking about that they passed,” Bradford said in an interview with the Arkansas News Bureau.
Starting Aug. 1, Arkansans who have been denied health insurance coverage for pre-existing conditions and have been uninsured for at least six months can apply for the Pre-existing Condition Insurance Plan, or PCIP. Coverage will begin Sept. 1.
The plan will exist until 2014, when the health insurance exchanges mandated by the federal law go into effect. Bradford said it will serve mainly working people, typically self-employed or employed by small businesses, who are able to afford moderately-priced insurance but have been turned down because of health conditions.
“It’s an answer for them to give them the security that they so desperately need,” he said.
The Patient Protection and Affordable Care Act, signed into law by President Obama in March, requires the creation of temporary high-risk insurance pools in every state, to be administered by the state, a nonprofit entity or the federal government.
Arkansas has chosen to administer its own pool through its Comprehensive Health Insurance Pool program, which already administers similar insurance pools in the state, Bradford said.
“There are 20-some-odd states who have just said, ‘We’re not going to administer that. Let the federal government do it.’ Well I can assure you that we can do it better here,” Bradford said.
The state’s CHIP pools, which are funded through premiums, will continue to operate separately from PCIP. Both CHIP and PCIP will cease to exist when the insurance exchanges become available in 2014.
Bradford said Arkansas will receive $46 million of $5 billion the federal government is providing to fund the new pools nationwide.
“It is a good deal for the state. It’s $46 million that will be paid on behalf of Arkansans’ health care, and it is 100 percent federal money,” he said.
Enrollment in Arkansas’ plan will be limited during the first year to 2,500 people, but the plan may be expanded in later years if claims do not eat up too much of the funding, Bradford said.
A broad range of benefits, including primary and secondary care, hospice care and prescription drugs, will be available to all participants. Non-tobacco users will pay monthly premiums ranging from $156 to $624, depending on the policy holder’s age, while tobacco users will pay premiums ranging from $202 to $807.
Policy holders’ out-of-pocket expenses will be capped at $2,000 per year.
Information on applying for the plan will be distributed to health insurance agents across the state next week. More information can be obtained by calling (800) 285-6477.